Rottmann discusses WISHIN 2.0, next steps for health information exchange 

The Wisconsin Statewide Health Information Network recently updated its underlying technical infrastructure and community health record, a project that’s been years in the making.

WISHIN 2.0 rolled out at the start of the month. It offers enhanced patient search, patient matching and in-depth clinical data views to the 2,000 care sites that participate in the statewide health information exchange, or HIE.

“We’re finally here,” CEO Steve Rottmann told Wisconsin Health News. “What this means is that we can bring more discrete data and streamlined access to clinical information in real time within a clinician’s workflow. The goal is to reduce clicks and have greater access to data that leads to better patient outcomes.”

Rottmann said the revamped system has technical functionalities that set the stage for artificial intelligence capabilities, higher data quality and connectivity via the Trusted Exchange Framework and Common Agreement, or TEFCA, which is a national framework for exchanging health data.

He anticipates that the majority of their users will start using WISHIN 2.0 in the next month or so.

In a recent interview, Rottmann talked about what’s next for WISHIN and interoperability.

Edited excerpts are below.

WHN: How does this revamped system improve users’ experience?

Rottmann: We’ve been able to incorporate underlying technology that easily incorporates into a clinician’s workflow within their (electronic health record). As I’m looking up a patient, I can see within my Epic, Cerner or whatever EHR that I have. I can also extend that view into WISHIN and make it part of my clinical workflow, and that will help in decision-making.

With that, we’re removing clicks. When you remove clicks, you bring back greater focus to the patient at those visits, so that together the patient and the provider can determine what that care plan looks like. When we have that in WISHIN, we can make that readily available to others on a care team. It starts with access. If the users find the system not sufficient, clunky or too many clicks, we’ve already lost. That’s been our goal: to flatten the environment so that individuals have a better user experience.

Some of the other features include favoriting a patient. When I favorite a patient, now they become part of a patient roster that I manage. Especially for care managers who have patients or members who move all over the healthcare delivery system, I can watch those patients’ activity play out in real time. I receive greater demographic information. I see when they have a visit at an emergency department. I can make a contact. I can reach out to those other individuals that have cared for the patient and bring that information together.

We’ve brought population dashboarding into the clinical workflow. We also organized the data into something that’s intuitive and exportable. If I need that information to live in my records, I can easily export that data to be usable within my own records. Those organizations can then use those records for managing the patient, but also quality reporting and potential stars ratings, and however else they may use that data for transactional or chronic disease management.

WHN: What are some of the remaining hurdles for interoperability? 

Rottmann: The post-acute providers, like skilled nursing facilities, assisted living facilities and palliative care, some of those organizations just simply can’t afford a system that offers them a seat at the table. That’s why we exist as an HIE. While interoperability at its core needs an EHR, we are very versatile in the way that we can bring the smaller, less technically sophisticated organizations to have a seat at the table. We have several home health agencies using WISHIN from a care management perspective and also for Medicaid waste, fraud and abuse protection.

Pharmacies have systems, but they don’t always interoperate natively or seamlessly. We’re trying to sit in the middle of those transactions and elevate the necessary information that’s needed, so that we can help enable pharmacists, especially now with their expansion of license, to act in accordance with their license as clinicians.

There are so many other examples. The adoption of an EHR was at the forefront 15 years ago. We have so much work ahead of us to make that happen broadly. I don’t see that happening in 10 or 15 years. Maybe in 50 years, everybody’s using a system. But in the meantime, that’s why WISHIN and several other HIEs exist. We need to sit in the middle as neutral data trustees. We need to start moving from that transactional ones and zeros moving of data into transformational data exchange and how that can enable community value.

WHN: What’s next for WISHIN? 

Rottmann: First, and this is not something we have done great in the past, is customer engagement. We work with a customer and talk to them about the benefits of health information exchange. We connect them, and they deploy the services within their organization. And then there’s been a lack, over the past 15 years of our existence, of coming back to those organizations and having meaningful dialogue. ‘What is the return? What are we doing well? What are we not doing so well?’ That is at the forefront because that feedback drives the value equation that we need to adopt and change per customer. That’s really setting the stage. That’s what the team has recently launched, and I’m thankful for that. It’s been long overdue.

And then it’s demonstrating a return on an investment. There are some returns that are obvious, but there are underlying needs in specialty care, rural health, clinically integrated networks and accountable care organizations. We need to have these conversations, bring groups together and provide feedback. That sets the stage for how we modify our governance in accordance to their needs, and we’ve done that in the past.

With that, and it ties into that last point, we’ve had several conversations — and this is really driven by our health plan participants — about how quality data is paramount. Without the quality data, they have additional work to do. My entire team’s goal is: How can we shortcut some of that administrative burden by taking on that quality assessment and modification to the data to meet the needs of quality measurement, like for the National Committee for Quality Assurance? And then it evolves into clinical insights, both population health and gaps in care. And, I would say in the future, not today: How do we use AI?

This article first appeared in the Wisconsin Health News daily email newsletter. Sign up for your free trial here.